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Difficulty: MediumPharmacological Therapies

A pediatric client arrives at the primary care clinic for a scheduled measles, mumps, and rubella (MMR) vaccine. During the initial data collection, the guardian reports that the child has been taking a prescribed high-dose oral corticosteroid for the past two weeks to treat a severe asthma exacerbation. Which action is the priority for the practical nurse?

  1. Withhold the vaccine and report the client's current medication therapy to the healthcare provider.Answer
  2. B
    Proceed with administering the vaccine since a history of asthma is not a reason to delay routine immunizations.
  3. C
    Educate the guardian about the specific immunological risks of receiving the vaccine and ask them to sign the consent form.
  4. D
    Calculate a modified, weight-based dose of the vaccine to reduce the risk of a systemic reaction.

Answer

The correct action is to withhold the vaccine and report the client's current medication therapy to the healthcare provider.
The MMR vaccine is a live-attenuated virus vaccine. High-dose systemic corticosteroids cause immunosuppression, which is a strict contraindication for receiving live vaccines due to the risk of severe infection. The practical nurse must prioritize client safety by recognizing this contraindication, withholding the vaccine, and reporting the finding to the healthcare provider.

Step-by-Step Solution

1
Analyze the client's current medication therapy in relation to the scheduled procedure.
The client is taking a high-dose oral corticosteroid, which causes systemic immunosuppression.
Identifying current medications is essential to prevent adverse drug interactions or complications.
2
Determine the characteristics of the scheduled vaccine.
The MMR vaccine is a live-attenuated virus vaccine.
Live vaccines carry a risk of causing active infection if administered to a client with a weakened immune system.
3
Apply the practical nursing scope of practice to the clinical finding.
The practical nurse must recognize the contraindication, withhold the administration, and promptly notify the provider or registered nurse.
Ensuring client safety by withholding contraindicated medications and reporting significant clinical data is a critical responsibility.

Key Concept

Immunization contraindications and safe medication administration within the practical nurse's scope of practice.
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Topics

Pharmacological Therapies

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